Provider Demographics
NPI:1215755970
Name:FIEDLER, EMILY (MSW, LSW)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:
Last Name:FIEDLER
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 BEACH AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:BRADLEY BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:07720-1639
Mailing Address - Country:US
Mailing Address - Phone:732-856-1440
Mailing Address - Fax:
Practice Address - Street 1:2130 NJ-35
Practice Address - Street 2:C- 311
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750
Practice Address - Country:US
Practice Address - Phone:732-947-4777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07177400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker